Development of a standardized screening method for detection of vancomycin-resistant enterococci

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Published inJournal of Clinical Microbiology Vol. 32; no. 7; pp. 1700 - 1704
Main Authors SWENSON, J. M, CLARK, N. C, FERRARO, M. J, SHAM, D. F, DOERN, G, PFALLER, M. A, RELLER, L. B, WEINSTEIN, M. P, ZABRANSKY, R. J, TENOVER, F. C
Format Journal Article
LanguageEnglish
Published Washington, DC American Society for Microbiology 01.07.1994
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Abstract Article Usage Stats Services JCM Citing Articles Google Scholar PubMed Related Content Social Bookmarking CiteULike Delicious Digg Facebook Google+ Mendeley Reddit StumbleUpon Twitter current issue JCM About JCM Subscribers Authors Reviewers Advertisers Inquiries from the Press Permissions & Commercial Reprints ASM Journals Public Access Policy JCM RSS Feeds 1752 N Street N.W. • Washington DC 20036 202.737.3600 • 202.942.9355 fax • journals@asmusa.org Print ISSN: 0095-1137 Online ISSN: 1098-660X Copyright © 2014 by the American Society for Microbiology.   For an alternate route to JCM .asm.org, visit: JCM       
AbstractList The incidence of vancomycin resistance among enterococci is increasing in the United States and elsewhere in the world, but automated susceptibility testing methods have difficulty detecting resistance expressed by certain strains. The agar screening method described by Willey et al. (B. M. Willey, B. N. Kreiswirth, A. E. Simor, G. Williams, S. R. Scriver, A. Phillips, and D. E. Low, J. Clin. Microbiol. 30:1621-1624, 1992) has been proposed as a reliable method for confirming vancomycin resistance. In this study, we investigated various parameters associated with the agar screening method and, on the basis of the findings, established optimum testing conditions for the method. First, to evaluate media and vancomycin concentrations, one laboratory used Mueller-Hinton and brain heart infusion agars supplemented with 4, 6, and 8 micrograms of vancomycin per ml to test 100 genetically characterized enterococcal strains. On the basis of the results obtained, brain heart infusion agar supplemented with 6 micrograms of vancomycin per ml was selected for further study. Subsequently, eight laboratories used the medium to test both reference and clinical isolates. There was very good performance with the reference strains and, among 158 clinical isolates tested, the method demonstrated sensitivity and specificity of 100% and from 96 to 99%, respectively.
The incidence of vancomycin resistance among enterococci is increasing in the United States and elsewhere in the world, but automated susceptibility testing methods have difficulty detecting resistance expressed by certain strains. The agar screening method described by Willey et al. has been proposed as a reliable method for confirming vancomycin resistance. In this study, we investigated various parameters associated with the agar screening method and, on the basis of the findings, established optimum testing conditions for the method. First, to evaluate media and vancomycin concentrations, one laboratory used Mueller-Hinton and brain heart infusion agars supplemented with 4,6, and 8 mu g of vancomycin per ml to test 100 genetically characterized enterococcal strains. On the basis of the results obtained, brain heart infusion agar supplemented with 6 mu g of vancomycin per ml was selected for further study. Subsequently, eight laboratories used the medium to test both reference and clinical isolates. There was very good performance with the reference strains and, among 158 clinical isolates tested, the method demonstrated sensitivity and specificity of 100% and from 96 to 99%, respectively.
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Author J M Swenson
R J Zabransky
F C Tenover
M P Weinstein
M J Ferraro
G Doern
N C Clark
D F Sahm
L B Reller
M A Pfaller
AuthorAffiliation Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333
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Issue 7
Keywords Enterococcus
Culture medium
Composition
Drug susceptibility test
Multicenter study
Standardization
Method
Resistance
Streptococcaceae
Antibiotic
Bacteria
Micrococcales
Detection
Comparative study
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PublicationTitle Journal of Clinical Microbiology
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2554802 - Antimicrob Agents Chemother. 1989 Sep;33(9):1588-91
1416893 - Antimicrob Agents Chemother. 1992 Sep;36(9):2005-8
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The incidence of vancomycin resistance among enterococci is increasing in the United States and elsewhere in the world, but automated susceptibility testing...
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SubjectTerms Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Culture Media - chemistry
Drug Resistance, Microbial
Enterococcus
Enterococcus - drug effects
Enterococcus - isolation & purification
Medical sciences
Microbial Sensitivity Tests - methods
Pharmacology. Drug treatments
Sensitivity and Specificity
Species Specificity
Vancomycin - pharmacology
Title Development of a standardized screening method for detection of vancomycin-resistant enterococci
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